Gen Abdomen, Liver/Gallbladder, Spleen

A correct rad of the abd should include the ___ cr and the __ cd

diahragm, hip jts

How do you tell the diff btw a R and L latera

the R has gas in the fundus, the L has gas in the pylorus

The pylorus is on the __ side of the animal

L

What organs are in the retroperitoneum?

kidneys, CV, Ao, adrenals, ureters,

List the organs inside the peritoneum

liver and gall bladder, sleen, urinary bladder, mesentery

What are the 2 major causes of poor serosal contrast/

extra soft tissue/fluid or not enough fat

Why is lower serosal contrast normal in animals <6m?

they have brown fat

What will peritonitis look like on rads?

poor serosal contrast

What are two artifacts that cause poor serosal contrast?

wet hair, underexosure

What are ddx for peritoneal nodules?

FIP, mycobacerium, fungus, neoplasia

You see soft streaking or hazy appearance to the organs. What could be cuasing this?

peritoneal effusion

What will peritoneal effusion look like on rads?

wispy clouds

What is the most common reason for exudative effusion?

septic peritonitis

What are examples of transudates/modified transudates?

hypoalbuminemia, vasculitis, right CHF

What are examples of less common effusions?

urine, bile, granulomatous disease (FIP), chyle

You see an anechoic fluid on US. What kind of fluid is this?

transudate/mod transudate

What are the 4 main quadrants where peritoneal effusion collects

urinary bladder, R kidney, L kidney, liver lobes

What are the causes of focal loss of serosal contrast?

small vol effusion, focal peritonitis, focal abd mass

What is a comm cause of focal peritonitis?

pancreatitis

What is reverberation artifact

dirty shadow on US indicating gas

If you are unsure of a pneumoeritoneum, what view can you take

horizontal beam view

What is the horizontal beam view

patient in left lateral recumbency

List the roentgen signs for organs on ultrasound

number, shape, margination, echogenicity, location, echotexture,

does the gallbladder live to the right or left of midline?

right

Do you see the gallbladder normally in dgos? cats?

no, sometimes

“central divisional” means which liver lobes?

quadrate and right medial

“Right divisional” means which liver lobes?

right lateral and caudate

Will the liver of a young animal be bigger or smaller?

bigger

brachys normally have ____ livers

smaller

What are your ddx for microhepatia?

PSS, microvascular dysplasia, hepatic cirrhosis/fibrosis, diaphragmatic hernia

a cr deviated gastric axis means _

microhepatia

exogenous corticosteroid admin or endocrine disease will have what imact on the liver

vacuolar hepatopathy (hepatomegaly)

What are your four main ddx categories for hepatomegaly?

vacuolar hepatopathy, hepatitis/infx, neoplasia, congestion

What are the most common causes of hepatic masses

neolasia, nodular hyperlasia

What are the two regions of concern with oacity changes to the liver

mineral or gas

You see a mineral oacity in the area of the liver that is branching. What is this

mineralization of the biliary tract

What are causes of focal, dystrophic mineralization??

neolasia, granulomas, endocrinopathy

What are causes of gas in the area of the liver

heatic abscess, emhysematous cholecystisi

What will liver gass look like on US

white marks with shadow

How does the opacity of the liver comare to the sleen on US

liver is hyoechoic/darker

the caudate rocess of the caudatae lobe wras around which kidney

right

The portal veins of the liver filter blood from the _____

GI and sleen

Heatic veins drain into which vessel

CdVC to return blood to the heart

Which vessels of the liver have a hyerechoic/white visualization

portal viens

Can you ID heatic arteries on US

no

How do you remember which vessels are blue and which are red?

blue away (heatic veins) red toward (portal veins

What does hepatomegaly look like on US

rounded edges

On US, you see that the liver does not cover the gallbladder entirely, but is still smooth. What is this

microhepatia from portosystemic shunt

You see a liver on US that is small and hyperechoic with irregular margins. What is this

hepatic cirrhosis/fibrosis

What kind of echogenicity would you exect with vacuolar hepatopathy, hepatitis, cholestasis, hepatic lipidosis, and round cell neoplasia?

hyperechoic

What are the most common reasosn for a hypoechoic/dark liver

lymphoma, leukemia

What are some reasosn for hypoechoic livers

acute hepatitis, amyloidosis, toxic hepatopathy, congesions

What are some indications of neolastic lesions in the liver

targetoid, irrecular, highly vascular,

T/F cats can have bilobed gallbladders

true

What are the sizes of common bile ducts in cats and dogs

<4mm, <3mm

Is it more common to find echogenetic material in the GB of dogs or cats

dogs

If material is found in teh GB of cats, what is a possible pathology?

hepatobiliary disease

What dogs are predisposed to mucoceles

shelties, border terriers, dogs with endocrinopathy

What tye of object would make distal acoustic shadowing in the GB

calculi (choleliths

What are the two main freasosn for thickened wall of the GB

edema, infalmmation

What are causes of edema around the GB

anahylaxis, CHF, fluid overload, hypoalbuminemia,

Which art of the spleen moves freely?

tail, head is trapped by gastrosplenic ligaments

It is uncommon to see the ___ part of the spleen in a cat

tail of the spleen

How much of the spleen is normal to see on the VD view in cats?

the whole thing

the spleen has what opacity compared to the liver and kidneys?

hyperechoic/whiter

What part of the spleen looks like Florida?

head

You Us the spleen and find what looks like a whale’s tail. What is this?

splenic vessels

What are spleen sizes for dogs?

small - 10-15, big 15-25

What is special about GSD spleens?

big

What does sedation and anesthesia do to spleens?

increases the size

What is the normal spleen size for cats?

8-10

What are your ddx for splenomegaly?

congestion, benign causes, splenitis, diffuse neoplasia

What will splenomegaly look like?

round spleen margin

What is a common cause of splenitis and splenomegaly in cats?

histo

What are some benign causes of splenomegaly?

extramedullary hepatopoisis, lymphoid hyperplasia,

You see a couple nodules on US of the spleen. What could this be

splenic lymphoma (if many) lymphoid hyperplasia (if few)

_____ is a common cause of hemoabdomen

hemangiosarcoma

What are 2 causes of hemoabdomen?

hemangiosarcoma and hematoma

the majority of hyperechoic nodules in the spleen are ____

benign

What is the most common type of hyperechoic nodul ein the spleen?

myelolipoma

If aspiration of a nodule is not possible, what is your alternative?

wait 2-4 wks if concerned, wait 3-6m if unconcerned

You see no blood flow on the spleen with doppler and there is a lacy appearance ot the parynchyma. What is this?

splenic torsion

You only see blood flow abscent in one focal part of the spleen and this part is also hypoechoic. What is this?

splenic infarction

What other definition can you correlate to a hypoechoic/darker liver on US?

hepatomegaly (same ddx: hepatitis, neoplasia, amyloidosis, congestion

You have a cat with hypoechoic liver/darker, splenic nodules, and peritoneal fluid. What is a likely ddx?

FIP or anything infectious

GB sludge is incidental in ____

dogs

You have a young animal with mild splenic nodules. What is your most likely ddx?

lymphoid hyperplasia (comm in young animals)

What will a hemangiosarcoma commonly look likeon US?

cavitated/dark

If a liver is rounded on US, this means there is ____

hepatomegaly

Will hepatic lipidosis make the liver lighter or darker? Bigger or smaller?

lighter and bigger

An old dog has a rounded liver on US. What does this mean for ddx?

rounded → hepatomegaly → vacuolar hepatopathy (bc of age)

What causes clean distal acoustic shadowing?

mineral

You have diffuse hypoechogenicity of the spleen on US and a history of azo and elevated enzymes. What is your ddx?

acute hepatitis → lepto

What do you call the artifact that obscures the edge of the bladder?

edge artifact